In certain circles, “getting work” isn’t about landing a barista gig at Starbucks. It’s about erasing that latticework of lines under your eyes or that marionette thing around the mouth that gives you an unfortunate Howdy-Doody look—like a permanent frowny face.

Help is just a laser beam away. Our area has many cosmetic surgeons who are using the latest techniques. And don’t think Joan Rivers on the red carpet. Folks who just want to feel good or even improve their chances in a bad job market are opting for cosmetic procedures.

WHEN I VISIT DR. GIL ALTMAN at his office in Englewood Cliffs, he sends a car service to pick me up. A courtesy more for carless writers than clients, it’s still a classy move that seems to fit the image of the cosmetic surgeon. I somehow can’t picture the colorectal guy sending a Town Car for the colonoscopy story.

I’m glad it’s a sunny day. It gives me an excuse to hide my eye wrinkles behind sunglasses without looking like a Blues Brother. The car makes its way upriver, sometimes hugging the Palisades. Soon we arrive at a modest and functional looking Altman Aesthetics Center.

The waiting area is empty of patients at the moment with lots of brochures and “products” on display. The staff is friendly. The entire setup seems designed to put the visitor at ease. Altman escorts me into his office, which is sunny and comfortable. He sports green scrubs, a really crispy white lab coat, and the smoothest skin I’ve ever seen on a homo sapien. He’s 40.

To say that he has a great bedside manner or is polite and gentlemanly is an understatement. It would be unthinkable for him to say, “Ya know lady, you could really use some work.” Still… you get the impression that he’s not just looking—but seeing.

But Altman insists he never suggests any procedure not already proposed by the patient. “I don’t want to have a woman come into my office and leave being bothered by something that was not bothering her when she came in,” he says. “If she comes in for rhinoplasty, I would never say get your eyes done, too. I would never do that to somebody.”

I ASK WHAT THE HOT PROCEDURES are these days. “It’s changed,” he says. “We used to do many more breast augmentations. It was a very popular thing, but now procedures are directed much more toward the face and contours of the body.” When I check back with Altman a couple of months later, turns out that breast augmentations are back. Apparently breast size fluctuates with the economy.

And in fact some patients seek face and body work, Altman says, because “they want to look young and competitive for the workforce.”

The age of Altman’s patients ranges from the 20s to the 70s. I’m shocked that someone in her 20s would want cosmetic surgery and wonder aloud if some people are just into cosmetic surgery—like Joan Rivers.

“She’s had way too much,” he smiles. “A patient in her ’30s who’s had 10 procedures, the last thing she needs is another procedure, she needs a good therapist.” In a case like that, Altman says, “I talk to them about it. You want to maintain your standards. I’m a human first, doctor second, plastic surgeon third. It’s important to do things that make them better.”

The benefits need to outweigh the risks. “Once operating, whether it’s a breast augmentation or cardiac bypass, there is the potential for risk,” he says. “The patient must understand and take it seriously.”

Ninety percent of Altman’s patients are women. “Men,” he says, “come in for Botox or liposuction for their flanks. They want to lose the love handles.” Altman says he always apologizes “when the needle goes in.” At one point, he wanted to see for himself what it was like so he injected some into his forehead. “It wasn’t too painful and I saw that it worked.”

As a surgeon, Altman describes himself as “very conservative.” Even Botox he considers invasive because it involves a “needle below the surface of the skin. The least risky are lasers, injectables, and topical cosmetics and medications.” A whole bunch of the latter are on display and for sale in cabinets in the waiting room. If I wanted to wisely spend a stimulus check, I would definitely spring for the topical cosmetics.

“I don’t do facelifts on 40-year-olds,” he says. “The youngest would be 55.”

He can do a lot with what he calls “injectables for facial rejuvenation,” banishing fine lines, crow’s feet, sunspots, wrinkles, and rosacea, which are red veins.

ALTMAN KNEW WHEN HE ENTERED MEDICAL SCHOOL that he wanted to be a plastic surgeon because it combines medicine and artistry. “I enjoy painting, sculpting, working with wood, stained glass, photography” he says. “It was the only thing I considered. It’s most rewarding to deal with the traumatic or congenital. It’s extremely rewarding to repair a child’s cleft palate. Being disfigured is not easy. It’s unfair but society judges us by how we look.”

But sometimes all his years of surgical training come down to a recommendation of diet and exercise. “When someone comes in who is morbidly obese and wants a tummy tuck or liposuction, I recommend a trainer.”

To be a good plastic surgeon, you need to talk to patients, listen to them, and be part shrink. “I love that part,” he says. It’s “what’s going on inside” that’s important. “It comes from within.”

During our conversation Altman has been playing with a silicone breast implant as if it were a kind of worry bead. He molds it, tosses it from hand to hand. I eye a pile of them on his desk, and he suggests I try it.

It’s better than popping bubble wrap.—Kate Rounds Dr. Gary D. Breslow

“During the recession, I’ve seen people opting for less costly and invasive cosmetic procedures, such as Botox,” says Dr. Gary Breslow, a Paramus-based cosmetic surgeon.

“Some patients are not ready for surgery but can look and feel good with injectable skin fillers once or twice a year.” Others, he says, “want to have surgery and be done with it.”

Breslow says that cosmetic work is no longer just for the wealthy. “I heard a lot of people take out loans,” he says, “and it’s a lot more affordable and commonplace. There are financing options for all these things, and women and men who aren’t upper class are getting a wide range of procedures. It’s acceptable to a wider population.”

“The stigma is gone,” he says, especially with the not-so-recent proliferation of TV shows like Dr. 90210, Extreme Makeover, Nip/Tuck,and The Swan.

Breslow’s main message to prospective patients? “Aging is a chronic, progressive, treatable condition that is not curable.”

He says, “Certain features in the 30s progress and become more obvious in the 40s and 50s. You can’t cure these things but you can treat them. If you have rhinoplasty for a bump on the nose when you’re 40 it’s not coming back, but you need upkeep with rejuvenation procedures to combat the aging condition.”

Patients, he says, often ask how many treatments they need. Do you go to a gym, he responds, and ask how many times you have to go to the gym to stay in shape?

To keep expectations in check, Breslow keeps a wizard hat and wand in his office. He says, “I impress on them that surgery is not magic. There are indications, risks. You can’t wave a wand and magically improve the condition. It doesn’t work like that.”—KR Dr. Robert Zubowski

“There’s been a resurgence of breast augmentation—number one, up from liposuction, which held the title for many years,” says Dr. Robert Zubowski. “I think the safety of implants has been established by FDA studies. People are savvy, aware of information, and have the comfort level to proceed.”

Zubowski, who has a Paramus practice, says that women come in for “natural augmentation, not large,” meaning that they’re not aiming for the Dolly Parton look.

He says that nonsurgical procedures were on the incline even before the economic downturn. But, he says, “given the economy, people who may have been ready for a facelift” are opting for “less invasive procedures.”

Though he sees more women than men—from the mid-40s to the 70s—he’s now seeing more men than he has in recent years. “The workplace is more competitive now,” he says. “Men want to look competitive. They may feel youthful and healthy but they want to look like they can compete with younger counterparts.” He says they get Botox injections as well as surgery on their eyelids, liposuction, and rhinoplasty.

His philosophy? “Realistic expectations are the biggest thing,” he says. “Our obligation is to educate the patient to do their homework. You can’t suction down from 200 pounds to 130.”

Liposuction, he says, won’t make you “look like Twiggy.”—KR Want Work?Here’s a partial list to help you in your research.Dr. Gil AltmanEnglewood Cliffs (201) 569-3334altmanaesthetics.com